Being treated like a dog ... ain't always so bad

fedgazette Editorial

No wonder U.S. health care reform is a hot issue. Since the mid-'60s,
we've doubled the share of national income going to health care. Yet many
of our citizens cannot get adequate care, and the alternatives, but the
choice was ours. We did not then have to wait until some review board
of medical experts or insurance representatives deliberated and eventually
(we hope) approved our decision. Instead, the vet immediately started
our chosen treatment and gave us Mick's medication to continue the treatment
at home.

Before we left, the vet also gave us a computer printout detailing
Mick's treatmentand one last choice. We could pay the bill
by check or by credit card. We had no forms to fill out and no follow-up
hassle getting a third party to pay our claim.

In sum, there was no muss, no fuss and no uncaring or unqualified
third party telling us what we could do. We made the choices, and
we bore their costs.

Our experience with Mick provides some insights about human health
care. One is that health care and health insurance are not inseparable.
Mick was able to get good care without any insurance. Similarly,
many people still can get good care even though they choose not
to buy insurance. And for many who would have to pay high premiums,
that can be a wise choice.

In contrast, there are many poor people who cannot afford either
health insurance or health care. Society's responsibility is to
provide them with the care, not the insurance. To do that, we should
be exploring other alternatives, like providing public clinics.

Another veterinary insight is that our health insurance system
imposes tremendous costs. There are the obvious costsborne
by doctors, patients and insurance companiesassociated with
completing and shuffling forms. These costs were completely avoided
with Mick's care. But more important are the costs associated with
poor decision-making. Because we were presented with the costs of
alternative care for Mick, we could make reasoned choices. That's
not true for the care for the rest of our family.

Human health insurance basically prepays for all health care,
so people have no incentive to choose cost-effective treatments
and doctors have no incentive to suggest them. Since neither has
the proper incentives, third parties, such as the government or
managed care units, must step in to limit choices or control prices.
Much of the bureaucracy, inefficiency and limitations on choice
can be attributed to the way we have decided to pay for our health
care services.

Let us return health insurance to its proper role: to protect
individuals against large potential losses. Let insurance cover
major medical expenses, but let individuals pay out-of-pocket for
ordinary expenses. Then maybe all of us can get as good health care
as Mick does.